JP2015037508A - Medical long member - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a medical long member which can implement smooth movement in a pulmonary airway and has excellent operability.SOLUTION: A long member 10 includes: a hollow bend 20 which is arranged on the tip side of the long member and is capable of being bent by bending operation; a hollow approach support part 40 arranged on the base end side of the bend; and a hollow main body part 50 which has flexibility and extends to the base end side of the approach support part. The bend is formed so as to: have a length which is equal to or larger than 10 mm and equal to or smaller than 60 mm; and have an outer diameter which is equal to or larger than 2.0 mm and equal to or smaller than 4.5 mm. The approach support part is formed so as to have a length which is equal to or larger than 10 mm.

Description

  The present invention relates to a medical long member used when performing a treatment in a lung airway.

  2. Description of the Related Art Long medical members used when performing various in-vivo treatments such as diagnosis of a patient's medical condition, treatment of a lesion, delivery of various media into a living organ, and the like are known.

  The elongate member is used, for example, to assist the movement of a medical device for acquiring a diagnostic image such as an endoscope to a lesion, or to remove a living tissue. It is used to guide a medical instrument such as a biopsy instrument to a lesion in a procedure to be performed. In addition, for example, it may be integrated with a catheter device, and may be used for delivery of various drugs into a living body or suction of body fluids existing in the living body.

  As described above, the elongate member can be used for various purposes, but in addition to this, there are various living organs to be applied. For example, it is called a lumen such as a blood vessel, a ureter, a bile duct, or a body cavity. Used in a wide range of areas. For this reason, in order to improve the operativity according to the biological organ used as application object, various devices are made to the elongate member. For example, in the long member described in Patent Document 1, a smooth movement in a branched peripheral blood vessel is realized by providing a tapered shape in which the outer diameter decreases toward the distal end side.

JP 2012-196389 A

  As described in Patent Document 1, a long member for medical use with improved followability to peripheral blood vessels has been developed so far. The development of the operability improvement in was not progressed. For this reason, when performing various treatments for the bronchus, long members used in other living organs have to be diverted. However, when such a long member is used, the following problems arise in terms of operability.

  The lung bronchus has a structure in which the diameter (cross-sectional area) decreases toward the distal side. For this reason, in order to reach the distal end side of the long member to the distal side, the outer diameter of the distal end portion of the long member needs to be the same as or smaller than the diameter of the distal side of the bronchus. . However, when the outer diameter of the long member is extremely reduced, a relatively large gap is formed between the long member and the inner wall of the bronchus, so that the followability of the long member to the bronchus is impaired. It will be. On the other hand, when the outer diameter of the long member is excessively larger than the diameter on the distal side of the bronchus, the long member becomes difficult to move due to friction with the inner wall of the bronchus. Therefore, it is necessary to operate the long member with a larger pushing force, and it becomes difficult to realize a safe and quick procedure.

  The present invention has been made in view of the above problems, and an object of the present invention is to provide a medical long member excellent in operability that can realize smooth movement in a lung airway.

  The present invention is achieved by the means described in any one of (1) to (11) below.

  (1) A medical long member used when performing treatment in the lung airway, which is disposed on the distal end side and can be bent by a bending operation, and a proximal end of the bending portion And a hollow main body portion having flexibility extending to the base end side of the entry auxiliary portion, and the bending portion is 10 mm or more. It is formed with a length of 60 mm or less and is formed with an outer diameter of 2.0 mm or more and 4.5 mm or less, and the entry assisting part is formed with a length of 10 mm or more. Element.

  (2) The said main-body part is a medical elongate member as described in said (1) currently formed by the length of 230 mm or more and 800 mm or less.

  (3) The main body includes a first tapered portion having an outer diameter that gradually increases from a distal end portion located on the proximal end side of the entry assisting portion toward the proximal end side, and a proximal end side of the first tapered portion. At least a second taper portion whose outer diameter gradually increases toward the base end side, and an extension portion extending to the base end side of the second taper portion, wherein the first taper portion is Formed with a length of 10 mm or more and 20 mm or less, and formed with an outer diameter of 2.0 mm or more and 6.0 mm or less, and the second tapered portion is formed with a length of 50 mm or more and 100 mm or less, and The outer diameter is 10 mm or more and 15 mm or less, and the extension portion is formed with an outer diameter that is equal to or larger than the base end of the second taper portion. Item 3. A medical long member according to Item 2.

  (4) The said approach assistance part is a medical elongate member as described in any one of said (1)-(3) whose outer diameter is larger than the said curved part.

  (5) The elongate member for medical use according to any one of (1) to (4), wherein the entry assisting portion has higher rigidity than the bending portion.

  (6) The medical elongate member according to (5), wherein the entry assisting portion has higher rigidity than the main body portion.

  (7) The said approach assistance part is a medical elongate member as described in any one of said (1)-(6) whose elasticity is smaller than the said bending part.

  (8) The medical aid according to any one of (1) to (7), wherein the entry assisting portion has an entry assisting portion side tapered portion whose outer diameter decreases from the proximal end side toward the distal end side. Long member.

  (9) The medical long member according to any one of (1) to (8), wherein an inner diameter of the hollow portion of the main body is larger than an inner diameter of the hollow portion of the curved portion.

  (10) The medical long member according to any one of (1) to (9), wherein a surface of the curved portion is covered with a coating material having slipperiness.

  (11) The long body for medical use according to any one of (1) to (10), wherein the main body has higher torque transmission than the curved portion.

  According to the invention described in (1) above, the bending portion provided on the distal end side is configured to be able to follow and move along the inner wall surface of the peripheral side portion of the lung airway, and bends. A long member excellent in operability that can realize smooth movement in the lung airway is configured to be able to assist the movement of the bending portion by the approach assisting portion arranged on the base end side of the portion. Can be provided.

  According to the invention described in (2) above, when the long member is introduced into the pulmonary airway orally or nasally, the distal end of the curved portion can surely reach the distal side of the bronchus. Various treatments in bronchioles and respiratory bronchioles can be suitably performed.

  According to the invention described in (3) above, the second taper of the main body portion is brought into contact with the inner wall surface of the subregion bronchus (fourth to fifth branches) of the lung airway. Since the part can be brought into contact with the bronchus (third branch to fourth branch) of the lung airway, the pushing force can be efficiently transmitted from the main body part to the distal end side, and the pushability of the long member Can be further improved. In addition, since the friction between the main body and the inner wall surface of the lung airway can be reduced by each tapered portion, it is possible to suitably prevent the damage to the inner wall surface of the lung airway. Furthermore, since the extension part can be moved along the inner wall surface without the clearance between the extension part and the inner wall surface on the central side of the bronchus, the operability of the long member can be further improved. Can do.

  According to the invention as described in said (4), the pushing force given from the hand side can be suitably transmitted to the curved part side via an approach assistance part, and the pushability of a long member is improved. Is possible.

  According to the invention described in (5) above, the pushing force applied from the hand side can be efficiently transmitted to the curved portion side via the approach assisting portion, and the pushability of the long member is further improved. It becomes possible to make it.

  According to the invention described in (6) above, it is possible to further improve the operability of the long member without impairing the pushability of the entry assisting portion.

  According to the invention as described in said (7), the elastic deformation of an approach assistance part can be suppressed and it can prevent that the transmissibility of the pushing force via an approach assistance part is impaired. Furthermore, since the bending portion can be moved on the distal side while being elastically deformed, the bending portion can be moved more smoothly.

  According to the invention as described in said (8), the friction between an approach assistance part and the inner wall face of a lung airway can be reduced, and it becomes possible to improve the pushability of a long member. Further, it is possible to prevent damage to the inner wall surface of the lung airway when the pushing operation is performed.

  According to the invention described in (9) above, when various medical devices and medical instruments are introduced into the lung airways using the long member, the medical devices and medical instruments are moved from the main body side to the curved portion side. It can be easily moved, and the carrying work can be easily performed. Furthermore, when the long member is applied to a suction device or a discharge device, the suction force can be improved or the discharge amount can be increased.

  According to the invention described in (10) above, it is possible to further improve the pushability of the long member by improving the slipperiness of the curved portion.

  According to the invention described in (11) above, the bending portion follows and operates when a rotation operation or a twisting operation is performed in a state where the bending portion is in contact with the inner wall surface on the distal side of the lung airway. It is possible to prevent the lung airway from being damaged and the like. Furthermore, since the torque transmission property of the main body is maintained, the main body can be moved while performing rotation and twisting operations, and it is possible to suppress a decrease in the operability of the long member.

It is a general-view perspective view which shows the medical elongate member which concerns on 1st Embodiment of this invention. It is a figure which simplifies and shows the cross section along the longitudinal direction of the medical elongate member which concerns on 1st Embodiment. FIG. 3 is a view showing a bending portion of the medical long member according to the first embodiment, wherein (A) is a partially enlarged view showing a part of the bending portion, and (B) is It is the elements on larger scale which expand and show the groove part formed in the curved part. It is a figure for demonstrating the usage example of the medical elongate member which concerns on 1st Embodiment, Comprising: It is a figure which shows a mode that the medical elongate member was introduce | transduced in the lung airway. It is a figure for demonstrating the usage example of the medical elongate member which concerns on 1st Embodiment, Comprising: The mode which moved the front-end | tip of the elongate medical member from the state shown in FIG. 4 to the distal side of the lung airway FIG. It is a figure for demonstrating the usage example of the medical elongate member which concerns on 1st Embodiment, Comprising: It is a figure which shows typically a mode that the front-end | tip part of the elongate medical member was reached to the respiratory bronchiole. is there. It is a figure for demonstrating the modification of the medical elongate member which concerns on 1st Embodiment, Comprising: (A) is a figure which shows the usage example of the medical device which concerns on a comparison, (B) is It is a figure which shows typically the usage example of the medical elongate member which concerns on a modification. It is a general-view perspective view which shows the medical elongate member which concerns on 2nd Embodiment of this invention. It is a general-view perspective view which shows the medical elongate member which concerns on 3rd Embodiment of this invention.

  Embodiments of the present invention will be described below with reference to the drawings. In addition, the dimension ratio of drawing is exaggerated on account of description, and may differ from an actual ratio.

<First Embodiment>
1-3 is a figure which shows the structure of each part of the medical elongate member which concerns on 1st Embodiment, FIGS. 4-6 is use of the elongate medical member which concerns on 1st Embodiment. It is a figure where it uses for description of an example. In the following description, the lower side in FIG. 1 is referred to as “the front end side of the long member”, the upper side in FIG. 1 is referred to as “the base end side of the long member”, and the vertical direction is “the longitudinal direction of the long member”. Called.

  Referring to FIG. 1, a medical long member 10 (hereinafter simply referred to as “long member”) according to the present embodiment is configured as a hollow member that can be bent, and is formed in the longitudinal direction. It has a stretched outer shape. As will be described later, when a predetermined operation is performed, the bending portion 20 provided in the long member 10 performs a bending operation. The elongate member 10 can be used to perform various treatments in the lung airway P. For example, delivery of an imaging device such as an endoscope or delivery of a biopsy instrument for collecting biological tissue, The elongate member 10 can be used for drug delivery, suction of body fluid, mucus, and the like. Moreover, it can also be used as a component member constituting a shaft portion of various access devices, an insertion portion of a flexible endoscope, a balloon catheter, or the like. In the description of the present embodiment, as shown in FIG. 6, a long time is given through an example in which a predetermined medical treatment instrument 150 is applied to a medical instrument 100 (access device) used to guide a desired position of the lung airway P. The scale member 10 will be described.

  First, each structure of the elongate member which concerns on this embodiment is demonstrated.

  As shown in FIG. 1 and FIG. 2, in brief, the long member 10 is disposed on the distal end side thereof, and is provided on the proximal end side of the bending portion 20 and a hollow bending portion 20 that can be bent by a bending operation. And a hollow main body portion 50 having flexibility and extending to the proximal end side of the entry auxiliary portion 40.

  On the proximal end side of the main body 50 provided in the long member 10, a hand operation unit 60 for operating the bending operation of the bending unit 20 is provided. The hand operating unit 60 and the long member 10 constitute a medical instrument 100.

  The curved portion 20 included in the long member 10 is provided to enable the traveling direction of the long member 10 to be determined at each branch of the lung airway P. As shown in FIG. 4, the living body's lung airway P has a plurality of branches from the central side (upper side in the figure) to the distal side (lower side in the figure). When various treatments using the long member 10 are performed, the distal end of the long member 10 is moved toward a desired position in the lung airway P. At this time, by bending the bending portion 20 as appropriate, It is possible to select an arbitrary route at the branch.

  The approach assisting portion 40 provided in the long member 10 has a function of assisting the movement when the bending portion 20 moves in the lung airway P. When a predetermined operation is performed at the hand operation unit 60, the bending unit 20 bends in conjunction with the operation. When the operation is not performed, that is, when no load is applied, the bending unit 20 is substantially straight. Flexibility to form a shape is provided. For this reason, when the operation of pushing the distal end of the long member 10 (the distal end of the bending portion 20) into the lung airway P is bent, the bending portion 20 is bent, and the smooth movement of the long member 10 is hindered. May be. Therefore, by providing the elongate member 10 with the entry assisting portion 40 configured so that the physical properties and the outer diameter shape are different from those of the bending portion 20, the bending portion 20 can be smoothly moved in the lung airway P. I have to.

  The main body 50 provided in the long member 10 is extended by a predetermined length along the longitudinal direction. The main body 50 is formed with a length that allows each of the bending portion 20 and the entry assisting portion 40 disposed on the distal end side thereof to reach a desired position in the lung airway P (see FIG. 6).

  The structure of the lung airway will be described with reference to FIG.

  The lung airways P are given different names in the central and peripheral regions. The names of each region are trachea P1, main bronchus P2, lobe bronchus P3, bronchi P4, bronchiole P5, terminal bronchiole P6, respiratory bronchiole P7, alveolar tract P8, and alveolar sac P9 from the central side, respectively. Yes. Moreover, in each area | region P1-P9, the diameter (cross-sectional area) differs as shown in figure, and a diameter becomes small, so that it goes to the distal side.

  Since the pulmonary airway P is configured as described above, for example, when various treatments are performed on the pulmonary airway P using the long member 10, the distal end of the long member 10 is reliably made to reach the treatment target site. In order to make this possible, the long member 10 having an outer diameter smaller than the diameter of the target region where the treatment target site exists is selected. However, if the outer diameter of the elongate member 10 is excessively smaller than the diameter of the target region, a large gap (clearance) is formed between the inner wall of the lung airway P and the elongate member 10, and the lung airway P The long member 10 cannot be moved along the inner wall, and the followability to the pulmonary airway P is reduced. In particular, when the elongate member 10 is moved in the region on the peripheral side of the lung airway P, it is required to operate with high precision in consideration of invasiveness to the living body, but the gap as described above is formed. If it is done, smooth movement following the lung airway P will be inhibited. In the present embodiment, the periphery (peripheral airway) of bronchiole P5, which is considered to be deeply related to the occurrence of lesions such as COPD, respiratory bronchiole P7 adjacent to alveolar passage P8 and alveolar sac P9, etc. The long member 10 is configured so that the operability in the target region can be improved.

  As shown in FIG. 2, the bending portion 20 is formed by a hollow member in which a distal end opening 21, a proximal end opening 22, and a lumen 23 connected to the distal end opening 21 and the proximal end opening 22 are formed. It is composed.

  A plurality of predetermined groove portions 24 forming a bending mechanism are provided on the outer surface of the bending portion 20 along the longitudinal direction (see FIG. 3A). The groove portion 24 is formed by forming a slit (cut) having a predetermined shape on the outer surface (or inner surface) of the hollow member constituting the bending portion 20. The processing method for inserting the slit can be selected according to the material of the material used for the bending portion 20 and is not particularly limited. For example, a known method such as laser processing or etching processing is used. You can choose.

  As a hollow member constituting the bending portion 20, for example, a metal material, a hard resin material, or the like can be used. As the metal material, for example, stainless steel and nickel titanium alloy can be used, and as the resin material, for example, PP (polypropylene), HDPE (high density polyethylene), PET (polyethylene terephthalate), PBT (polybutylene terephthalate). Rigid polyethylene such as, hard urethane, PI (polyimide), polystyrene, PEEK (polyether ether ketone), polyamide, polyether imide, polyamide imide, modified polyferene ether, polycarbonate and the like can be used.

  The bending operation of the bending portion 20 can be performed by operating the operation member 70 connected to the bending portion 20. As shown in FIG. 3A, the operation member 70 can be attached to an attachment portion 71 formed on the outer surface of the bending portion 20. The attachment portion 71 may be configured by, for example, a groove-shaped fixing portion 72 disposed on the distal end side of the bending portion 20 and an insertion groove 74 that extends from the distal end side to the proximal end side of the bending portion 20. it can.

  For example, the operation member 70 can be configured by a push-pull member that deforms the bending portion 20 into a curved shape or a linear shape by being pushed and pulled along the longitudinal direction of the long member 10. The push-pull member can be constituted by, for example, a string-like member, a wire, a flexible plate material, or the like.

  The push-pull member can be attached to the bending portion 20 by arranging and fixing the push-pull member in the fixing portion 72 and further arranging and fixing the push-pull member in the insertion groove 74. By fixing in this way, the push-pull member can be pulled to start the bending operation of the bending portion 20, and by releasing the pulled force, the bending operation is released to be bent so as to form a linear shape. The part 20 can be deformed.

  For example, the insertion groove 74 can be formed at a position different from the position where the groove portion 24 is formed in the long member 10. In the illustrated example, the positions of the groove portions 24 are shifted by 90 ° in the circumferential direction (the insertion grooves 74 are shifted by 180 ° in the circumferential direction). By arranging in this way, it is possible to prevent the grooves 24 and the operation member 70 from interfering with each other. In the long member 10, the position where the operation member 70 is disposed is not limited to the insertion groove 74, and can be disposed, for example, in the lumen 23 of the bending portion 20.

  For example, the fixing portion 72 can be provided with a fixing auxiliary portion 73 for fixing the push-pull member more firmly to the bending portion 20. The fixing auxiliary portion 73 can be configured by a groove formed to extend from the fixing portion 72 in the circumferential direction of the bending portion 20 with a predetermined length. Fixing force can be improved by fixing the push-pull member in a state where the push-pull member is positioned so as to be locked to the fixing auxiliary portion 73.

  As a method for fixing the operation member 70 to the bending portion 20, any method can be selected according to the material of the bending portion 20 and the operation member 70. For example, a method of fixing with a resin adhesive, A method of fixing by fusion or the like can be employed.

  For example, two operation members 70 can be attached with the position shifted by 180 ° in the circumferential direction of the long member 10. As shown in FIG. 2, the base end portion of each operation member 70 is connected to a rotation member 65 provided in the hand operation portion 60. The rotating member 65 is pivotally supported with respect to a rotating shaft (not shown) provided in the hand operation unit 60. When the rotating member 65 is rotated in the direction of arrow A, the bending portion 20 is bent in one direction (the direction of arrow A ′ in FIG. 1), and when the rotating member 65 is rotated in the direction of arrow B, the bending portion 20 is the other. It is comprised so that it may curve to the direction (arrow B 'direction in FIG. 1). In FIG. 2, the operation member 70 is illustrated in a simplified manner. However, the operation member 70 is, for example, the outer surface side of the bending portion 20 and the inside of the approach assisting portion 40 so as not to interfere with other constituent members. Further, it can be extended to the rotating member 65 via the inside of the main body 50 and the inside of the hand operating unit 60.

  As shown in FIG. 3A, the curved portion 20 can be covered with a predetermined cover material 75 having elasticity. By covering the cover material 75, the suction efficiency of body fluids, secretions, and the like from the distal end opening 21 of the bending portion 20 can be improved. Further, it is possible to prevent fluid from leaking from the groove portion 24 formed in the bending portion 20 or the like. Furthermore, it is possible to protect the bending portion 20 and the living body, and it is possible to configure the bending portion 20 so as to be elastically deformable because elasticity is added to the bending portion 20. In addition to this, it is possible to prevent the operation member 70 from dropping from the insertion groove 74.

  Examples of the material constituting the cover member 75 covered with the long member 10 include polyolefins such as polyethylene (PE) and polypropylene (PP), polyesters such as polyethylene terephthalate (PET), polyamide (PA), and polyimide (PI). ), Polyamideimide (PAI), silicone, polyurethane (PU), ethylene-vinyl acetate copolymer (EVA), polyvinyl chloride (PVC), polytetrafluoroethylene (PTFE), polyvinylidene fluoride (PVDF), perfluoro Fluorine resins such as alkoxy fluororesin (PFA), thermoplastic resins such as thermoplastic elastomer, and the like can be used.

  FIG. 3B is an enlarged view showing a part of the groove 24 constituting the bending mechanism. In the groove portion 24, a predetermined gap g and a guide portion 31 engaged with the gap g are formed. When the operation member 70 is operated, the guide portion 31 moves within the gap g. The movement is transmitted along the longitudinal direction of the bending portion 20 so that the entire bending portion 20 is bent. For example, as shown in the figure, by providing a support point 32 that supports the guide portion 31 so as to be able to swing, the movement of the guide portion 31 can be satisfactorily transmitted along the longitudinal direction.

  As shown in FIG. 2, the entry assisting section 40 is a hollow member in which a distal end opening 41, a proximal end opening 42, and a lumen 43 connected to the distal end opening 41 and the proximal end opening 42 are formed. It is composed by.

  In this embodiment, the approach assistance part 40 has a function as a connection member that connects the bending part 20 and the main body part 50. The base end of the bending portion 20 is inserted into the distal end opening portion 41 of the entry assisting portion 40 and is fitted with the insertion. The bending portion 20 is fixed to the entry assisting portion 40 by this fitting. On the other hand, the connection portion 44 formed by reducing the diameter of the proximal end portion of the entry assisting portion 40 is inserted into the distal end opening 51 of the main body portion 50 so that the outer surface thereof is covered with the main body portion 50, and accompanying the insertion. It is mated. The entry assisting part 40 is fixed to the main body part 50 by this fitting. In this way, the bending portion 20 and the main body portion 50 are connected to each other via the entry assisting portion 40.

  The cross-sectional shape of the lumen 43 of the entry assisting portion 40 can be formed into a tapered shape whose diameter gradually decreases from the proximal end side toward the distal end side, for example.

  As a material constituting the entry assisting portion 40, for example, the same material as that constituting the hollow member constituting the bending portion 20 can be used. However, as will be described later, the bending portion 20, the approach assisting portion 40, and the main body portion 50 can be configured to have different physical properties so as to have a desired function. Therefore, an arbitrary material can be selected as the material constituting the entry assisting portion 40 according to the relationship with the material used for the bending portion 20 and the main body portion 50.

  As shown in FIG. 2, the main body 50 includes a hollow member in which a distal end opening 51, a proximal end opening 52, and a lumen 53 that is continuous with the distal end opening 51 and the proximal end opening 52 are formed. It is composed by.

  The distal end of the main body portion 50 is connected to the connection portion 44 of the entry assisting portion 40 through the distal end opening 51. Moreover, the base end of the main-body part 50 is inserted in the front-end | tip opening part 61 of the hand operation part 60, and is fitted with insertion. The main body 50 is fixed to the hand operating unit 60 by this fitting.

  As a material constituting the main body 50, a flexible material can be used. For example, polyvinyl chloride, polyethylene, polypropylene, cyclic polyolefin, polystyrene, poly (4-methylpentene-1), polycarbonate, Acrylic resin, acrylonitrile-butadiene-styrene copolymer, polyester such as polyethylene terephthalate, polyethylene naphthalate, butadiene-styrene copolymer, polyamide (for example, nylon 6, nylon 6,6, nylon 6,10, nylon 12) Various rubber materials such as natural rubber, butyl rubber, isoprene rubber, butadiene rubber, styrene-butadiene rubber, and silicone rubber can be used. Further, for example, the main body portion is formed by a tubular member including a screw tube formed by spirally winding a belt-shaped plate, a mesh-like net that covers the screw tube, and a resin outer skin that covers the outer peripheral surface of the net. Can be configured.

  The hand operating unit 60 includes a distal end opening 61 into which the base end of the main body 50 is inserted, a space 62 extending in the longitudinal direction, a support 63 for assisting the forward and backward movement of the operating member 70, and a base end And the rotation member 65 used for pushing and pulling the operation member 70.

  The space portion 62 of the hand operation unit 60 is disposed coaxially with the lumen 23 of the bending portion 20, the lumen 43 of the entry assisting unit 40, and the lumen 53 of the main body 50. The space 62 and the lumens 23, 43, and 53 form a working lumen for inserting a predetermined medical device or other medical instrument into the medical instrument 100. For example, when the medical instrument 100 or the like is delivered into the pulmonary airway P using the medical instrument 100, the medical instrument 100 is inserted into the hand operation unit 60 through the insertion opening 64 formed in the hand operation unit 60. Let Then, the treatment instrument 150 is inserted into the working lumen and guided to the treatment target site by projecting the distal end portion from the distal end opening 21 of the bending portion 20.

  The rotating member 65 of the hand operation unit 60 is rotatably attached while being connected to the operating member 70. On the surface of the rotating member 65, a concavo-convex portion on which a finger can be hung is formed. As shown in FIG. 1, for example, the bending operation of the bending portion 20 can be performed by a simple operation of rotating the rotating member 65 using a finger of one hand.

  As a material constituting the hand operation unit 60, for example, a hard plastic material or a metal material can be used.

  Next, dimensions and physical properties of each part of the long member will be described.

  With reference to FIG. 2, the length L1 of the bending part 20 in the longitudinal direction is formed with a length of 10 mm or more and 60 mm or less. This is due to the following reason. In addition, the length L1 of the bending part 20 demonstrated here is the length of the part exposed from the approach assistance part 40, and the length of the part covered with the approach assistance part 40 is not included.

  As shown in FIG. 4, when moving the long member 10 toward the distal side, the long member 10 is moved along the lung airway P by moving the long member 10 in contact with the inner wall surface of the lung airway P. The scale member 10 can be moved. During the initial stage of insertion, that is, while the elongate member 10 is moved on the central side, for example, the elongate member 10 is curved with respect to the inner wall surface of the lobe bronchus P3 (periphery of the second branch) located on the central side. By bringing the portion 20 into contact (hooking), the long member 10 can be moved smoothly. However, if the length L1 of the bending portion 20 is smaller than the diameter of the main bronchus P2 (periphery of the first branch), the bending portion 20 may bend to the bending portion 20 while the bending portion 20 is moving along the main bronchus P2. When bending occurs, it becomes difficult to make the curved portion 20 reach the lobe bronchus P3. Therefore, the length L1 of the bending portion 20 is set so that the diameter of the general main bronchus P2 is 10 mm or more. In order to more reliably prevent the above problems from occurring, it is more preferable that the length L1 of the bending portion 20 is 14 mm or more.

  After the distal end of the bending portion 20 reaches the peripheral airway, when the operation of pushing the elongate member 10 to advance the bending portion 20 further toward the distal side is performed, the extension toward the distal side causes the maximum due to the extension of the peripheral airway. It is possible to move 60 mm. For this reason, by setting the upper limit of the length L1 of the bending portion 20 to 60 mm, the bending portion 20 is formed unnecessarily long while allowing a wider area of the peripheral region to be included in the treatment target site. To prevent that. Since the peripheral airway extends 40 mm or more, the length L1 of the bending portion 20 is more preferably 40 mm or less from the viewpoint of preventing the bending portion 20 from being formed unnecessarily long.

  With reference to FIG. 2, the outer diameter D1 of the bending part 20 is formed in 2.0 mm or more and 4.5 mm or less. This is due to the following reason. In addition, the outer diameter of the curved part 20 demonstrated here means the outer diameter including the thickness dimension of the cover material 75, when using the cover material 75, and when using the coating material mentioned later, it is the thickness of a coating agent. It means the outer diameter including dimensions.

  The diameter of the respiratory bronchiole P7 is generally 0.5 to 1.0 mm. When the bending portion 20 is pushed into the respiratory bronchiole P7, the respiratory bronchiole P7 extends up to about 1.0 mm to 2.0 mm. Therefore, when the outer diameter of the bending portion 20 is 2 mm, it is possible to move the bending portion 20 in a state where it is in contact with the inner wall surface of the respiratory bronchiole P7. Moreover, it is preferable that the diameter R1 of the lumen 23 of the bending portion 20 is 1 mm or more so that various medical devices and medical instruments 100 can be inserted. Also from the viewpoint of the diameter R1 of the lumen 23, the outer diameter of the bending portion 20 is 2 mm or more.

  The diameter of the peripheral airway is generally 2.0 mm. When the bending portion 20 is pushed into the peripheral airway, the peripheral airway extends up to about 4.5 mm at the maximum. Therefore, when the outer diameter of the bending portion 20 is 4.5 mm, it is possible to move the bending portion 20 in a state where it is in contact with the inner wall surface of the peripheral airway. For this reason, the upper limit of the outer diameter D1 of the bending part 20 is set to 4.5 mm. Since the peripheral airway may only extend to about 3.5 mm, the outer diameter D1 of the bending portion 20 is more preferably 3.5 mm or less from the viewpoint of invasiveness.

  With reference to FIG. 2, the length L2 of the longitudinal direction of the approach assistance part 40 is formed with the length of 10 mm or more. This is due to the following reason. In addition, the length L2 of the approach assistance part 40 demonstrated here is the length of the part exposed from the main-body part 50, and the length of the part covered with the main-body part 50 is not included.

  When the bending portion 20 is moved by the peripheral airway or the respiratory bronchiole P7, for example, the entry assisting portion 40 is brought into contact with the lobe bronchus P3 located on the central side (see FIG. 6). Thus, it is possible to suitably transmit the pushing force to the bending portion 20 located on the distal end side. However, if the length L2 of the entry assisting portion 40 is smaller than the diameter of the lobe bronchus P3, the entry assisting portion 40 is disposed sideways in the lobe bronchus P3, and the contact assisting portion 40 is in contact with the lobe bronchus P3. The problem of not being able to maintain is possible. In order to prevent such a problem from occurring, the length L2 of the entry assisting portion 40 is set so that the diameter of the general lobe bronchus P3 is 10 mm or more. In order to more reliably prevent the above problems from occurring, it is more preferable that the length L2 of the bending portion 20 is 15 mm or more.

  With reference to FIG. 2, in the long member 10, the length L <b> 3 in the longitudinal direction of the main body 50 is formed to be 230 mm or more and 800 mm or less. The length L3 of the main body 50 described here is the length of the portion exposed from the hand operation portion 60, and does not include the length of the portion covered by the hand operation portion 60.

  Since the main body 50 is formed with the length L3 as described above, when the elongate member 10 is introduced into the pulmonary airway P orally or nasally, the distal end of the bending portion 20 is introduced from the bronchus P4. Since it is possible to reliably reach the peripheral side, various treatments in the peripheral airway including the bronchiole P5 and the respiratory bronchiole P7 can be suitably performed.

  With reference to FIG. 2, in the long member 10, the outer diameter D <b> 2 of the entry assisting portion 40 is formed larger than the outer diameter D <b> 1 of the bending portion 20. For this reason, as shown in FIG. 5, it is possible to perform an operation of moving the bending portion 20 on the distal side while maintaining the state in which the approach assisting portion 40 is in contact with the central inner wall surface. Since the pushing force applied from the hand side is suitably transmitted to the bending portion 20 side via the approach assisting portion 40, the pushability of the long member 10 is improved. In addition, the outer diameter D2 of the approach assistance part 40 can be formed in 3.0 mm-5.0 mm, for example, and the outer diameter D1 of the bending part 20 is formed in 2.0 mm-4.5 mm, for example. Can do.

  The long member 10 is configured such that the rigidity of the entry assisting portion 40 is greater than the rigidity of the bending portion 20. By configuring in this way, it becomes possible to efficiently transmit the pushing force applied from the hand side to the curved portion 20 side via the approach assisting portion 40, so that the pushability of the long member 10 is further improved. This can be further improved. Further, the long member 10 is configured such that the rigidity of the entry assisting portion 40 is greater than the rigidity of the main body portion 50. By comprising in this way, the operativity of the elongate member 10 can be improved further, without impairing the pushability of the approach assistance part 40. FIG.

  The long member 10 is configured such that the elasticity of the entry assisting portion 40 is smaller than the elasticity of the bending portion 20. By comprising in this way, the elastic deformation of the approach assistance part 40 is suppressed, and it is preventing that the transmission property of the pushing force via the approach assistance part 40 is impaired. Further, the bending portion 20 can be moved on the distal side while being elastically deformed, and the bending portion 20 can be moved more smoothly.

  The approach assisting portion 40 is provided with an approach assisting portion-side tapered portion 45 whose outer diameter decreases from the proximal end side toward the distal end side. By providing such a tapered portion 45, friction between the entry assisting portion 40 and the inner wall surface of the lung airway P can be reduced, and the pushability of the long member 10 can be improved. Moreover, it is possible to prevent the inner wall surface of the lung airway P from being damaged when the pushing operation is performed.

  The long member 10 is configured such that the diameter R3 of the lumen 53 (hollow portion) of the main body 50 is larger than the diameter R1 of the lumen 23 (hollow portion) of the bending portion 20. For this reason, when introducing the various treatment tools 150 into the lung airways P using the long member 10, the treatment tool 150 can be easily moved from the main body 50 side to the bending portion 20 side. . In addition, when the long member 10 is applied to a suction device or a discharge device, it is possible to improve the suction force or increase the discharge amount. The diameter R3 of the lumen 53 of the main body 50 can be formed, for example, to 2.0 mm to 4.5 mm, and the diameter R1 of the lumen 23 of the bending portion 20 is, for example, 1.2 mm to 3. It can be formed to 7 mm.

  The surface of the curved portion 20 can be covered with a coating material having slipperiness. By improving the sliding property of the curved portion 20, the pushability of the long member 10 is further improved. As the coating material, a material that forms a coating film on the surface of the curved portion 20 or a material that is configured as a film material that covers the surface of the curved portion 20 can be used. Further, when the cover member 75 is provided on the curved portion 20, a configuration in which a coating material is applied from above the cover member 75 can be adopted. As the coating material, for example, a hydrophilic material or a hydrophobic material can be used.

Examples of hydrophilic materials include cellulose-based polymer materials, polyethylene oxide-based polymer materials, and maleic anhydride-based polymer materials (for example, maleic anhydride copolymers such as methyl vinyl ether-maleic anhydride copolymer). Acrylamide polymer substances (for example, polyacrylamide, polyglycidyl methacrylate-dimethylacrylamide (PGMA-DMAA) block copolymer), water-soluble nylon, polyvinyl alcohol, polyvinylpyrrolidone and the like. In many cases, such a hydrophilic material exhibits lubricity when wet (water absorption), and reduces frictional resistance (sliding resistance) with the inner wall of a wet biological organ. Thereby, the slidability of the long member 10 is improved, and the operability is further improved.

  Examples of the hydrophobic material include polyamide, polyimide, polyurethane, polystyrene, silicone resin, fluorine resin (PTFE, ETFE, etc.), or a composite material thereof. Even when such a hydrophobic material is used, the same effect as that of the hydrophilic material described above can be exhibited.

  Note that the inner surface of the inner cavity 23 of the bending portion 20 may be covered with a coating material. By comprising in this way, the operation | work which inserts the treatment tool 150 in the bending part 20, or the operation | work which extracts can be performed smoothly.

  The long member 10 is configured such that the torque transmission performance of the main body 50 is higher than the torque transmission performance of the bending portion 20. By configuring in this way, when the bending operation is performed in a state where the bending portion 20 is in contact with the inner wall surface on the distal side of the lung airway P, the bending portion 20 follows and operates. Therefore, it is possible to prevent the lung airway P from being damaged. On the other hand, since the torque transmission property of the main body 50 is maintained, the main body 50 can be moved while performing a rotation or twisting operation, and a decrease in the operability of the long member 10 can be suppressed.

  Next, the usage example of the elongate member which concerns on this embodiment is demonstrated.

  Referring to FIG. 4, the site on the distal end side of medical device 100 from the central side of lung airway P, that is, the distal end of bending portion 20 of long member 10 is inserted into lung airway P. Insertion can be performed, for example, orally or nasally.

  After the distal end of the bending portion 20 reaches the first branch, the bending portion 20 is bent as shown in the drawing so that the distal end of the bending portion 20 is directed in a desired direction. The operation of moving the long member 10 can be performed while appropriately determining the course of the long member 10 using an imaging means such as an endoscope. In this work, an image including the distal end side of the long member 10 in the visual field is obtained by causing the endoscope to protrude from the distal end opening 21 of the bending portion 20 through a working lumen formed inside the medical instrument 100. Is possible. By repeatedly projecting the endoscope from the distal end opening 21 of the bending portion 20, confirming the state of the distal end side of the long member 10, and moving the long member 10 forward, the long portion along the desired path is obtained. The member 10 can be moved.

  Referring to FIG. 5, elongate member 10 is further pushed toward the distal side of lung airway P. At this time, the main body portion 50 and the bending portion 20 of the long member 10 are brought into contact with the inner wall surface of the lung airway P in each region of the lung airway P, so that the long member 10 is moved following the lung airway P. Is possible.

  With reference to FIG. 6, the long member 10 is pushed forward until the bending portion 20 of the long member 10 reaches the respiratory bronchiole P7 located on the distal side. When the long member 10 reaches the respiratory bronchiole P7, the inner wall surface of the respiratory bronchiole P7 and the curved portion 20 come into contact with each other, so that the curved portion 20 can be moved along the inner wall surface of the respiratory bronchiole P7. become. While the bending portion 20 is moved in the respiratory bronchiole P7, the entry assisting portion 40 of the long member 10 is brought into contact with the inner wall surface of the lobe bronchus P3, for example. Since the pushing force can be suitably transmitted to the bending portion 20 side via the entry assisting portion 40, the bending portion 20 can be moved more smoothly.

  After the distal end of the bending portion 20 reaches a desired position of the lung airway P, the treatment instrument 150 is introduced through the medical instrument 100. By using the treatment instrument 150, various treatments can be performed from a position close to a treatment target site existing on the peripheral side. As the treatment tool 150, for example, a biopsy device, an ultrasonic diagnostic apparatus, a microcatheter, an ablation device, a cryocatheter, a high-frequency ablation catheter, a microwave ablation catheter, a PDT probe, or the like can be used. In addition, when the endoscope is used together, the operation | work which replaces an endoscope with the treatment tool 150 is performed suitably.

  After the predetermined treatment is performed, the procedure is terminated by performing an operation of removing the medical instrument 100 from the living body. Note that the same procedure may be repeated to perform an operation of moving the long member 10 again toward another treatment target site, and the procedure may be continued.

  As described above, the elongate member 10 according to the present embodiment is configured such that the bending portion 20 provided on the distal end side can follow and move along the inner wall surface of the distal side portion of the lung airway P. And since it is comprised so that the movement of the bending part 20 can be assisted by the approach assistance part 40 arrange | positioned at the base end side of the bending part 20, the operativity which can implement | achieve the smooth movement in the lung airway P It will be excellent.

  Further, since the length L3 of the main body 50 is formed with a length of 230 mm or more and 800 mm or less, when the elongate member 10 is introduced into the lung airway P orally or nasally, the bending portion 20 The distal end can surely reach the distal side of the bronchus P4, and various treatments in the peripheral airway including the bronchiole P5 and the respiratory bronchiole P7 can be suitably performed.

  Moreover, since the outer diameter D2 of the entry assisting part 40 is formed larger than the outer diameter D1 of the bending part 20, the pushing force applied from the hand side is suitable for the bending part 20 side via the approaching assistance part 40. Therefore, the pushability of the long member 10 can be improved.

  Moreover, since the rigidity of the approach assistance part 40 is comprised so that it may become larger than the rigidity of the bending part 20, the pushing force provided from the hand side is efficiently passed through the approach assistance part 40 to the bending part 20 side. The pushability of the long member 10 can be further improved.

  Further, since the rigidity of the entry assisting part 40 is configured to be greater than the rigidity of the main body part 50, the operability of the long member 10 is further improved without impairing the pushability of the entry assisting part 40. It becomes possible.

  In addition, since the elasticity of the entry assisting portion 40 is configured to be smaller than the elasticity of the bending portion 20, the elastic deformation of the entry assisting portion 40 is suppressed, and the transferability of the pushing force via the entry assisting portion 40 is improved. It can be prevented from being damaged. Furthermore, since the bending portion 20 can be moved distally while being elastically deformed, the bending portion 20 can be moved more smoothly.

  Further, since the entry assisting portion 40 is provided with an entry assisting portion-side tapered portion 45 whose outer diameter decreases from the proximal end side toward the distal end side, the entry assisting portion 40 and the inner wall surface of the lung airway P are separated from each other. The friction between them can be reduced, and the pushability of the long member 10 can be improved. Further, it is possible to prevent damage to the inner wall surface of the lung airway P when the pushing operation is performed.

  In addition, since the diameter R3 of the lumen 53 of the main body 50 is configured to be larger than the diameter R1 of the lumen 23 of the bending portion 20, various treatment tools 150 are pulmonary using the long member 10. When introduced into the airway P, the treatment instrument 150 can be easily moved from the main body 50 side to the bending portion 20 side, and the transfer operation can be easily performed. Furthermore, when the long member 10 is applied to a suction device or a discharge device, it is possible to improve the suction force or increase the discharge amount.

  Further, since the surface of the curved portion 20 is covered with a coating material having slipperiness, the slipperiness of the curved portion 20 can be improved, and the pushability of the long member 10 can be further improved. Become.

  In addition, since the torque transmission property of the main body 50 is higher than the torque transmission property of the bending portion 20, the rotation operation is performed in a state where the bending portion 20 is in contact with the inner wall surface on the distal side of the lung airway P. When the twisting operation is performed, it is possible to prevent the bending portion 20 from following the movement, and it is possible to prevent the lung airway P from being damaged or the like. Furthermore, since the torque transmission property of the main body 50 is maintained, the main body 50 can be moved while performing a rotation or twisting operation, and it is possible to suppress a decrease in the operability of the long member 10.

<Modification>
As shown in FIG. 7A, when the medical device 400 is inserted into the upper lobe bronchus P ′ in a treatment using the medical device 400 such as a conventional long member for medical use or a bronchoscope having a reduced diameter. The medical device 400 needs to be greatly bent (meandered), and the direction in which the force is applied (indicated by an arrow f in the figure) and the traveling direction of the medical device 400 are reversed. The medical device 400 may not advance as expected because the forward force is not transmitted. In particular, when the distal end of the medical device 400 is inserted into the upper right lobe and advanced from the segmental bronchus (third branch to fourth branch) to the subregional bronchus (fourth to fifth branch), the long axis of the medical device 400 The bending of the part occurs in the middle bronchial trunk, and as shown in the figure, it may be J-turned and fall off as it is. Looking at the endoscopic image, when the tip enters the upper right lobe and it is pushed forward as it is, the upper lobe branch suddenly moves away and the right main trunk becomes visible.

  In the long member 10 ′ according to the modification shown in FIG. 7B, the length of the entry assisting portion 40 is longer than the diameter of the intermediate bronchial trunk. Further, the elasticity is formed to be relatively small, or the rigidity and the outer diameter are formed to be relatively large. According to the long member 10 ′, when the treatment using the long member 10 ′ is performed, the entry assisting portion 40 can be hooked on the inner wall surface of the intermediate bronchial trunk. 10 can be suitably prevented from occurring, and the operability is further improved.

Second Embodiment
Next, with reference to FIG. 8, the medical elongate member 200 which concerns on 2nd Embodiment of this invention is demonstrated. The same members as those described for the long member 10 according to the first embodiment are denoted by the same reference numerals, and description thereof is omitted.

  As shown in FIG. 8, in the long member 200 according to the present embodiment, a first tapered portion 254, a second tapered portion 255, and an extending portion 256 are provided on the main body portion 50. The main body portion 50 is different from the long member 10 according to the first embodiment in that the tapered portions 254 and 255 and the extending portion 256 are provided.

  The structure of each taper part and extension part is demonstrated.

  The first tapered portion 254 is configured such that the outer diameter gradually increases from the distal end portion of the main body portion 50 located on the proximal end side of the entry assisting portion 40 toward the proximal end side. The second tapered portion 255 is configured to extend to the proximal end side of the first tapered portion 254 and to gradually increase the outer diameter toward the proximal end side. The extending portion 256 is configured to extend from the second tapered portion 255 to the proximal end side with a constant outer diameter.

  The length L4 in the longitudinal direction of the first taper portion 254 is formed to be 10 mm or more and 20 mm or less. Moreover, the outer diameter D4 of 1 taper part is formed in 2.0 mm or more and 6.0 mm or less.

  The length L5 in the longitudinal direction of the second taper portion 255 is formed to be 50 mm or greater and 100 mm or less. Further, the outer diameter D5 of the second tapered portion 255 is formed to be 10 mm or more and 15 mm or less.

  The extending portion 256 is formed with an outer diameter D6 that is equal to or larger than the base end of the second tapered portion 255.

  In the procedure using the elongate member 200 configured as described above, the first tapered portion 254 of the main body 50 is brought into contact with the inner wall surface of the subregion bronchus (fourth to fifth branches) of the lung airway P. However, since the second tapered portion 255 of the main body 50 can be brought into contact with the regional bronchus (third to fourth branches) of the lung airway P, the pushing force is efficiently transferred from the main body 50 to the distal end side. Therefore, the pushability of the long member 10 can be further improved. In addition, since the friction between the main body 50 and the inner wall surface of the lung airway P can be reduced by the tapered portions 254 and 255, it is preferable to prevent the inner wall surface of the lung airway P from being damaged. Is possible. Furthermore, since the extension part 256 can be moved along the inner wall surface without the clearance between the extension part 256 and the inner wall surface on the central side of the bronchus, the operability of the long member 200 is further improved. Can be improved.

  In the illustrated example, the main body 50 is provided with two tapered portions having different outer diameters and lengths. However, the number of the tapered portions is not particularly limited, and two or more tapered portions can be provided. is there.

<Third Embodiment>
Next, with reference to FIG. 9, the elongate medical member 300 which concerns on 3rd Embodiment of this invention is demonstrated. The same members as those described for the long member 10 according to the first embodiment are denoted by the same reference numerals, and description thereof is omitted.

  As shown in FIG. 8, in the long member 300 according to the present embodiment, the entry assisting portion 40 is not formed with a tapered portion. The entry assisting portion 40 can be changed as long as it has a function capable of assisting movement of the bending portion 20 in the lung airway P by being formed so as to have different physical properties and outer shape from the bending portion 20. is there. Therefore, like the long member 300 according to the present embodiment, it is possible to omit the formation of the tapered portion on the entry assisting portion 40.

  As mentioned above, although the elongate member which concerns on this invention was demonstrated through several embodiment, this invention is not limited only to each embodiment mentioned above, It can modify suitably based on description of a claim. Is possible.

  For example, the configuration of the bending portion provided in the long member is not limited to that in which the bending operation is performed by the bending mechanism formed by the groove, and is configured by juxtaposing cylindrical members such as node rings in the longitudinal direction. It may be what was done. Further, the configuration and the like of the hand operation unit can be changed as long as the bending portion can be bent. Moreover, it is also possible to use only a long member alone as a medical instrument without providing a hand operation unit. In addition, the illustrated medical treatment tool and treatment content are examples, and it is naturally possible to perform various treatments using treatment tools other than those illustrated.

  In addition, for example, a balloon configured to be expandable / shrinkable by injecting and discharging fluid known in the medical field can be disposed on the distal end side of the long member. When a drug or the like is administered via a long member, the balloon can be expanded, so that the administration operation can be performed in a state where the position of the long member is fixed, and the drug can be efficiently administered. Is possible. In addition, since the peripheral side is blocked with a balloon and the drug or the like can be administered to the tip side from the blocked site, the drug can be administered locally. When a balloon is used, the balloon may be disposed so as to cover the cover member 75, or may be disposed directly on the outer surface of the long member. The balloon is connected to the fluid introduction lumen so that the fluid can be introduced from the proximal side, and is expanded by introducing the fluid from the fluid introduction lumen. The fluid introduction lumen may be disposed on the outside or the inside of the elongated member. The balloon is made of an elastic material such as silicone. Accordingly, it is possible to work in a state in which the long member is fixed at a predetermined position while being in close contact with the living body lumen when the balloon is expanded. Moreover, it is not restricted to this, You may arrange | position in the state which folded the material which does not expand-contract, such as nylon and polyethylene. By being composed of such a material, it becomes possible to expand a stenosis that occurs in the bronchi.

10, 10 ', 200, 300 Long member,
20 curved part,
21 Tip opening,
22 proximal opening,
23 lumen,
40 Assistance section,
41 Tip opening,
42 proximal opening,
43 lumen,
45 taper part 50 approaching auxiliary part side body part,
51 Tip opening,
52 proximal opening,
53 lumens,
60 Hand control unit,
70 operation members,
100 medical devices,
150 treatment tool,
254 first taper portion,
255 second taper portion,
256 extension,
P Lung airway.

Claims (11)

A medical long member used when performing a treatment in the lung airway,
A hollow curved portion disposed on the distal end side and bendable by a bending operation;
A hollow approach aid provided on the proximal side of the curved portion;
A flexible hollow main body portion extending to the proximal end side of the entry assisting portion,
The curved portion is formed with a length of 10 mm or more and 60 mm or less, and is formed with an outer diameter of 2.0 mm or more and 4.5 mm or less,
The said approach auxiliary | assistance part is a medical elongate member currently formed by the length of 10 mm or more.   The medical long member according to claim 1, wherein the main body is formed with a length of 230 mm or more and 800 mm or less. The main body includes a first tapered portion having an outer diameter gradually increasing from a distal end portion located on the proximal end side of the entry assisting portion toward the proximal end side, and a base extending toward the proximal end side of the first tapered portion. At least a second taper portion whose outer diameter gradually increases toward the end side, and an extension portion extending to the base end side of the second taper portion,
The first taper portion is formed with a length of 10 mm or more and 20 mm or less, and is formed with an outer diameter of 2.0 mm or more and 6.0 mm or less,
The second taper portion is formed with a length of 50 mm or more and 100 mm or less, and is formed with an outer diameter of 10 mm or more and 15 mm or less,
The long member for medical use according to claim 1 or 2, wherein the extending portion is formed with an outer diameter that is equal to or larger than a base end of the second tapered portion.   The medical elongate member according to any one of claims 1 to 3, wherein the entry assisting portion has an outer diameter larger than that of the bending portion.   The medical elongate member according to any one of claims 1 to 4, wherein the entry assisting portion has higher rigidity than the curved portion.   The medical approach elongate member according to claim 5, wherein the entry assisting portion has higher rigidity than the main body portion.   The medical elongate member according to any one of claims 1 to 6, wherein the entry assisting portion is less elastic than the bending portion.   The medical entry member according to any one of claims 1 to 7, wherein the entry assisting portion includes an entry assisting portion side tapered portion whose outer diameter decreases from the proximal end side toward the distal end side.   The medical elongate member according to any one of claims 1 to 8, wherein an inner diameter of a hollow portion of the main body portion is larger than an inner diameter of a hollow portion of the curved portion.   The medical elongate member according to any one of claims 1 to 9, wherein a surface of the curved portion is covered with a coating material having slipperiness.   The said main-body part is a medical elongate member of any one of Claims 1-10 whose torque transmission property is higher than the said curved part.